Active Military Duty If an employee is called to active military duty and elects not to continue coverage while on active duty, the employee may re-enroll for coverage upon return from active duty. The employee must apply for coverage within 31 days from the date he returns from active duty. The pre-existing condition exclusion period will be waived to the extent the employee and any covered dependents had previously satisfied the exclusion period before active duty began, if the employee applies for coverage within the 31-day period. If the employee returns within the same calendar year and applies for coverage within the 31-day period, the employee and any covered dependents will not be required to satisfy a new calendar year deductible.
What Are COBRA Benefits? COBRA (short for Consolidated Omnibus Budget Reconciliation Act of 1986) is a federal law that allows for continuation of coverage under an employer’s group health plan to covered persons (called “qualified beneficiaries”) in the event of a qualifying event.
Who is a Qualified Beneficiary? A qualified beneficiary is an individual who, on the day before the qualifying event, is covered under the Plan either as an employee, enrollee’s dependent spouse, or enrollee’s dependent child. A qualified beneficiary is also a child born to the employee, or who is placed for adoption with the employee during a period of COBRA continuation coverage.
What is a Qualifying Event? A qualifying event is an occurrence which, but for the continuation coverage available under the Plan, would result in the loss of coverage for a qualified beneficiary.
Under COBRA, qualifying events include the loss of coverage that otherwise would result due to:
Termination of employment, for reasons other than gross misconduct Reduction in hours of employment Death of the enrollee Divorce or legal separation Entitlement to Medicare Loss of dependent eligibility
If the qualifying event is divorce, legal separation, or ineligibility of a dependent child, the employee or qualified beneficiary must notify the employee’s employer unit no later than 60 days after the qualifying event occurs; otherwise, continuation coverage may not be made available. Any other enrollee or his qualified beneficiary must notify Blue Cross & Blue Shield no later than 60 days after the qualifying event occurs; otherwise, continuation coverage may not be made available.